Despite increasing concern about recent increases in the non-medical use of prescription drugs (non-medical use is defined as "use of a prescription drug either more than was prescribed, or without a prescription with the intention to get high"), little is known about the nature and extent of the problems related to the misuse of these drugs among adolescents, as well as about the potential correlates and polydrug use patterns associated with non-medical prescription drug use, abuse and dependence in adolescence. To fill this gap, this study will: 1) Estimate associations of non-medical prescription drug use with demographic characteristics (including living in urban, suburban or rural areas, socio-economic status and insurance status), frequency of use, deviant behaviors, sensation-seeking and mental health treatment and test whether these associations change over time, 2) Explore polydrug use patterns among non medical prescription drug users and investigate for different correlate associations within different polydrug use subgroups testing whether these associations change over time, 3) Test for variation in the prevalence of non-medical prescription drug use and factors associated with non-medical prescription drug use by age, gender, and insurance status subgroups, 4) Test whether age of onset pattern of NMPD has changed over time, 5) Estimate the prevalence of nonmedical prescription drug abuse and dependence over time, to examine whether the prevalence of abuse and dependence among nonmedical prescription drug users has changed over time, and to investigate associations of non-medical prescription drug abuse/dependence with demographic characteristics, frequency of NMPD use, deviant behaviors, sensation-seeking, mental health treatment, and patterns of other drug use over time, 6) Explore the prevalence and different patterns of polydrug abuse/dependence among adolescents who meet criteria for nonmedical prescription drug abuse/dependence over time, and test for different covariate associations, 7) test whether time from onset of use of NMPD to dependence on NMPD has changed over time. In all aims we will control for neighborhood characteristics. We propose to use eight years of data (1998-2005) of the National Survey on Drug Use and Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA). Exploratory data analyses, conditional logistic regression models and survival analyses techniques will be used to address each of the specific aims. Analyses proposed in this application on this rich database have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S. Our effort is directed at a greater congruence between surveillance data and dynamic conceptual models that are guiding etiologic and prevention research supported by NIDA. By examining whether the surge in NMPD among adolescents has resulted in an increase in regular use of NMPD and of NMPD abuse and dependence among adolescents, we will be able to contribute to the development of public policies that target to minimize consequences of NMPD. PUBLIC HEALTH RELEVANCE: Analyses proposed in this application on this rich database. (NHSDA/NSDUH) have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S and may contribute to the development of public policies that target to minimize consequences of NMPD.